{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:35:58Z","timestamp":1786649758788,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The phrenic nerve (PN) is not an exception to the variations. Recent cadaveric studies report that the third and fifth cervical nerves may be involved. The PN communicating branch might be considered as another option to neurotise the suprascapular nerve. The variants of the relationship between the subclavian vein and the PN should be familiar to anesthesiologists during subclavian vein cannulation to achieve a successful vein approach without causing PN palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      The study was carried out on both sides of 42 head and neck regions, which were obtained from the Department of Anatomy, KGMU, Lucknow. The study received Institutional Ethics Committee approval (\n                      <jats:italic toggle=\"yes\">Ref. code: XIV-PGTSC-IIA\/P78<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result:<\/jats:title>\n                    <jats:p>Classical three root (C3,4,5), double root with varying contribution from C3 or C5 (C3,4\/C4,5), and single root (C4\/C5). Classical triple root PN formation was present in 57.68% of cases and was the most common pattern in our study population. The second most common (30.95%) formation was observed for the double root pattern (C4,5) by contribution of distal cervical segment (C5). Double root configuration of C3,4 was observed on 4.76% sides. Out of single root contribution incidence of C4 pattern was higher (4.76%) as compared to C5 (2,14%). One cadaver exhibited a dual C5 root with C4 on the right side in a male cadaver.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although researchers have demonstrated that the PN nucleus extends locally from spinal cord segments C3 to C5, histological findings suggest that maximum contribution is derived from the C4 spinal nerve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njms.njms_172_23","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T06:01:39Z","timestamp":1756620099000},"page":"285-291","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Variational anatomy of cervical part of phrenic nerve: An observational human cadaveric study"],"prefix":"10.4103","volume":"16","author":[{"given":"Ankit","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Anatomy, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Rani","sequence":"additional","affiliation":[{"name":"Department of Anatomy, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind K.","family":"Pankaj","sequence":"additional","affiliation":[{"name":"Department of Anatomy, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoti","family":"Chopra","sequence":"additional","affiliation":[{"name":"Department of Anatomy, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punita","family":"Manik","sequence":"additional","affiliation":[{"name":"Department of Anatomy, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh K.","family":"Dewan","sequence":"additional","affiliation":[{"name":"Department of Anatomy, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s00276-018-2123-0","article-title":"Variant communication of phrenic nerve in neck","volume":"41","author":"Goyal","year":"2019","journal-title":"Surg Radiol Anat"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1080\/10790268.2007.11753947","article-title":"Effect of spinal cord injury on the respiratory system: basic research and current clinical treatment options","volume":"30","author":"Zimmer","year":"2007","journal-title":"J Spinal Cord Med"},{"key":"R4-20260420","first-page":"100123","article-title":"A study on the variants of phrenic nerve roots with histological correlation","volume":"23","author":"Andrade","year":"2021","journal-title":"Transl Res Anat"},{"key":"R5-20260420","first-page":"255","article-title":"Anatomical study of phrenic nerve course in relation to neck dissection","volume":"37","author":"Hamada","year":"2015","journal-title":"SurgRadiol Anat"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"153182","DOI":"10.1155\/2014\/153182","article-title":"The use of the phrenic nerve communicating branch to the fifth cervical root for nerve transfer to the suprascapular nerve in infants with obstetric brachial plexus palsy","volume":"2014","author":"Al-Qattan","year":"2014","journal-title":"Biomed Res Int"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/bja\/aeq373","article-title":"Variable Anatomical Relationship of Phrenic Nerve and Subclavian vein: Clinical Implication for Subclavian Vein Catheterization","volume":"106","author":"Papaskevas","year":"2011","journal-title":"Br J Anaesth"},{"key":"R8-20260420","first-page":"806","article-title":"From Charcot to Lou Gehrig: Deciphering selective motor neuron death in ALS. 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